Entries in Pediatric
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Joseph Powling / Facebook(NEW YORK) -- Three-month-old Joey Powling is the latest Internet meme, thanks to his cool smirk just five days after open-heart surgery.

The baby best known to the world as “Ridiculously Good-Looking Surgery Baby” was born with tetralogy of Fallot, a heart defect that hampered blood flow to his lungs.

“The lower ventricles didn’t grow and connect, leaving a little hole there,” said, Joey’s dad, Joe Powling, who found out about the defect when his wife was 24 weeks pregnant. "It was kind of nerve-wracking."

Because the lungs keep the blood rich with oxygen, babies with tetralogy of Fallot need early surgery to correct the problem.

“The long term risk of arrhythmias is lower, and the function of the heart is much better if the repair is done earlier,” said Dr. Christopher Snyder, chief of pediatric cardiology at Rainbow Babies and Children’s Hospital in Cleveland.

On Oct. 25, the Powlings held their breath during the 7-hour procedure.

“It felt like forever,” said Joe Powling. “You have no control over the situation. There’s really nothing you can do.”

The surgery to repair tetralogy of Fallot has been around since the 1960s, according to Snyder.

“It’s the first heart defect that we were actually able to fix,” he said, adding that the prognosis after surgery is good. “There is no simple cardiovascular surgery, but this repair’s been going on for a long time.”

Joey’s surgery went well, but he was hooked up to a ventilator for two more days, according to his dad.

“He was still intubated and had about 15 different lines and tubes into him,” said Joe Powling. “But by the fifth day he was back to himself.”

That’s when the Powlings snapped the now-famous photo, which, with more than 1.6 million likes on Facebook, has been transformed into a string of Internet memes like, “If Chuck Norris had a baby, he’d almost be as tough as this.”

But Joey’s not out of the woods yet. He might need a second round of surgery in a year, according to his father.

In the meantime, the Powlings are using their Internet fame to raise awareness about tetralogy of Fallot.

“So many children are born with congenital heart disease, and the world needs to know that it is common and it can be treated,” they said on their website, JoeyHeartsYou.com. “With the proper medical attention, many children can grow up to live normal lives. Joey wants you to know that it will be okay.”

(MADISON, Wisc.) -- While lethal heart problems in otherwise healthy children are rare, doctors say there are a number of conditions that could explain a sudden cardiac death or life-threatening heart attack in young patients.

The first important distinction to make is between a heart attack and cardiac arrest, says Dr. Amy Peterson, a pediatric cardiologist from American Family Children's Hospital in Madison, Wisc.

Heart attack occurs when there is an insufficient amount of blood delivering oxygen to the heart and part or all of the heart muscle begins to die. This could be due to blockages in the arteries, heart disease, or structural abnormalities of the heart muscle or the arteries. Cardiac arrest, on the other hand, refers simply to a heart that has lost its rhythm and stops beating, which could occur for a number of different reasons, she says.

"In general, heart attack in children is extraordinarily rare and when kids present with chest pain it is at the bottom of the list of things we suspect," Peterson says.

Cardiac arrest is less rare but still very uncommon, she says, but there are a number of ways that parents can be on the lookout for undiagnosed heart conditions that may cause a problem.

True heart attack in children can occur in rare circumstances where there is a genetic predisposition to exceptionally high cholesterol. In this case, a child who may or may not be overweight can suffer from arterial blockages similar to those which cause heart attack in adults with hypercholesterolemia, Peterson says. In these cases, a family history of severe high cholesterol is the best indicator that a child might be at risk for this kind of problem.

Other reasons for heart attack would include a structural abnormality of the heart or arteries that a child would be born with.

So what can a parent do to protect their child against sudden cardiac death?

In some cases, diagnosis can be incredibly difficult as the first symptom of a problem will be cardiac arrest or sudden death. Examples of this have been widely publicized in cases of teen athletes who drop dead seemingly out of nowhere on the field or court. While these instances are devastating, Dr. Rene Herlong, a pediatric cardiologist with Singer Heart & Vascular Institute, urges parents to not become overly worried that this might happen to their child as it "is rare as walking outside and getting hit by lightning."

But if your child suffers from chest pain, especially during exercise, or faints during exercise, this is something that should be checked out by a medical professional as it could be a sign of a heart condition, Herlong adds.

Knowing the family history and being aware of any genetic predispositions towards heart conditions is one of the best things a parent can do, Peterson says. And when a heart attack or cardiac arrest occurs, it is essential to give the child basic life support in the form of CPR or defibrillation, if a defibrillator is available, as soon as possible until advanced life support from medical professionals arrives.